Affordability: current estimates suggest 33 million individuals face catastrophic health expenditure due to payment for surgery and anaesthesia each year and a further 48m from additional costs from transport, food or loss of earnings.

Surgery is an indivisible, indispensable part of health care and thus must be integrated within the health system and is essential to universal health coverage.

The statement said: "The Colleges undertake to promote research on access to safe, affordable and timely surgery, reporting on the WHO's and the Lancet Commission's recommended surgical indicators. We will progress these within our region and support low and middle income countries with whom we partner and will report progress at the October 2015 American College of Surgeons Congress and subsequently at the May 2016 Royal Australasian College of Surgeons Congress."